Organization
METRO INFECTIOUS DISEASE CONSULTANTS, LLC
Active
Organization
METRO INFECTIOUS DISEASE CONSULTANTS, LLC
Active
Other names
MIDC, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA KOWALSKI (CREDENTIALING MANAGER)
(888) 220-6432
Entity
Organization
Contact information
Practice address
13657 W MCDOWELL RD, SUITE 118, GOODYEAR, AZ 85395-2601
(623) 328-7794
(623) 328-7932
Mailing address
901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527-0871
(888) 220-6432
(630) 734-4715
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
780223
—
AZ
Enumeration date
03/06/2013
Last updated
07/21/2022
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